Non-HDL-C/TC ratio: a useful screenings test for dysbetalipoproteinemia

Familial dysbetalipoproteinemia (FD) is a genetic lipid disorder, caused by a mutation in the apolipoprotein E (APOE) gene, and characterized by an increased number of cholesterol-enriched remnant lipoproteins in the plasma and premature cardiovascular disease. In the Frederickson classification of lipid disorders, FD was initially described as type III hyperlipoproteinemia (1). Usually FD patients respond well to dietary restrictions (2) and treatment with statins and fibrate in combination (3). Early diagnosis of FD is important for timely treatment, including risk factor management, dietary advice and drug treatment, as well as screening of family members. Unfortunately FD is often overlooked in the differential diagnosis of combined hypertriglyceridemia and hypercholesterolemia (4), mainly due to the fact that clinical clues are often lacking and the formal diagnosis needs specialized laboratory testing.